Model System:
BurnReference Type:
JournalAccession No.:
Journal:
Archives of Physical Medicine and Rehabilitation
Year, Volume, Issue, Page(s):
, epub, ,Publication Website:
Abstract:
OBJECTIVE: To examine differences in long-term employment outcomes in the postacute care setting.
DESIGN: Retrospective review of the prospectively collected Burn Model System National Database.
SETTING AND PARTICIPANTS: A total of 695 adult survivors of burn injury enrolled between May 1994 and June 2016 who required postacute care at a Burn Model System center following acute care discharge were included. Participants were divided into 2 groups based on acute care discharge disposition. Those who received postacute care at an inpatient rehabilitation facility (IRF) following acute care were included in the IRF group (N=447), and those who were treated at a skilled nursing facility, long-term care hospital, or other extended-care facility following acute care were included in the Other Rehab group (N=248).
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Employment status at 12 months postinjury. Propensity score matching and logistic regression were utilized to determine the effect of postacute care setting on employment status.
RESULTS: Individuals in the IRF group had larger burns and were more likely to have an inhalation injury and to undergo amputation. At 12 months postinjury, the IRF group had over 9 times increased odds of being employed compared to the Other Rehab group, using propensity score matching (P=.046).
CONCLUSIONS: While admitting patients with more severe injuries, IRFs provided a long-term benefit for survivors of burn injury in terms of regaining employment. Given the current lack of evidence-based guidelines on postacute care decisions, the results of this study shed light on the potential benefits of the intensive services provided at IRFs in this population.
Author(s):
Espinoza, LF, Simko, LC, Goldstein, R, McMullen, KA, Slocum, C, Silver, JK, Herndon, DN, Suman, OE, Meyer, WJ, Gibran, NS, Kowalske, K, Zafonte, R, Ryan, CM, Schneider, JC